Provider Demographics
NPI:1245588326
Name:KAAKEH, BAKRI (MD)
Entity Type:Individual
Prefix:
First Name:BAKRI
Middle Name:
Last Name:KAAKEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 COOPER AVE STE 4100
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-5182
Mailing Address - Country:US
Mailing Address - Phone:989-583-4700
Mailing Address - Fax:
Practice Address - Street 1:4701 TOWNE CENTRE RD STE 301
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2800
Practice Address - Country:US
Practice Address - Phone:989-401-1040
Practice Address - Fax:989-401-1154
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD178439208G00000X
390200000X
MI4301117108208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program